The present application relates to apparatuses and methods for managing liquid wastes associated with patients confined to a hospital bed, wheelchair, treatment table or the like.
The management of incontinence of a patient is an especially burdensome chore. A large number of patients are unable to control their bowels and bladders or are sufficiently incapacitated that they are unable to transport themselves to conventional toilet facilities when the need arises. When such patients suffer an episode of bowel and/or bladder incontinence, they may be subjected to a relatively prolonged period of time contacting the waste products so produced. In addition to being socially unacceptable for the patient, the waste products can cause skin maceration and breakdown. Moreover, cleaning the patient and the bedding pose especially undesirable chores for the nursing staff and thus adversely affect nursing morale. Moreover, each episode can require up to 20 to 40 minutes of nursing time to clean up a single patient who has suffered an incontinence event. For some patients, up to 40% of nursing time devoted to such patient is devoted to clean up activities associated with incontinence events. In addition, a single nurse is often incapable of turning the patient to the degree needed for adequate cleansing of the patient after an incontinence event. Thus, more than one member of the nursing staff must be involved in the clean up chore.
One method currently employed to manage bladder incontinence is to catheterize the patient. This method does not require any positive-effort or cooperation of the patient. However, in-dwelling catheters often cause infection which is one of the leading causes of death in older patients who have been so catheterized.
Devices such as disclosed in U.S. Pat. No. 4,631,762 to Fugett, require the patient to be aware that an incontinence event is imminent and further require the patient to be able to indicate same to the nursing staff or to take action to activate the device to assume a configuration ready to accommodate an incontinence event. For example, the Fugett device requires a section of the mattress to be removed and a toilet seat to be raised flush with the level of the mattress. Other devices which require reconfiguration before they are ready to accommodate an incontinence event, are disclosed in U.S. Pat. Nos. 3,014,224 to Hall; 3,129,438 to Hall; 3,503,083 to Barnett; 3,562,824 to White; 3,605,138 to Tucker; 4,054,959 and 4,085,471 to DiMatteo et al; 4,258,445 to Zur; 4,821,348 to Pauna; 4,754,508 to Nishiguchi; 4,800,599 to Korchinski et al; 4,805,249 to Usman et al; and 5,001,790 to Kuhn. Moreover, such devices can require significant moving about of the patient. Such movement is particularly undesirable for certain types of patients, for example those with sensitive skin conditions like decubitus ulcers. Furthermore, such devices are not readily adaptable to certain types of patient supports such as low air loss beds like the ones disclosed in U.S. Pat. Nos. 4,745,647 to Goodwin, 4,949,414 to Thomas et al, and 5,003,654 to Vrzalik because of the extensive pneumatic "plumbing" which exists beneath the main horizontal weight-bearing support structures forming such beds.
A device such as disclosed in U.S. Pat. No. 5,023,967 to Ferrand contains inflatable support cushions with a large opening 540 (FIGS. 58 and 60) formed in the region of the cushions disposed to receive the excretory organs of the patient so that any excreted wastes fall into the opening. However, such devices severely restrict movement of the patient in a manner that would misalign the patient's excretory organs with the opening in the cushions. Moreover, such devices fail to support the patient's backside in a manner sufficient for the patient's comfort. Other devices which have large nonsupportive openings in the middle of the patient support surface are disclosed in U.S. Pat. Nos. 3,757,355 to Allen et al and 2,656,549 to Osbon et al.
Other devices such as disclosed in U.S. Pat. Nos. 3,757,356 to Freeman, 4,870,710 to Hartmann, and 5,001,790 to Kuhn rest atop the normal support surface of the bed and thus involve all of the discomforting drawbacks of an uneven support surface.
Still other devices such as disclosed in U.S. Pat. No. 4,965,900 to Smith present several drawbacks, not the least of which is the failure to address the odor problem and the failure to signal the staff of the occurrence of an incontinence event by any means other than the malodor arising long after the event. Moreover, such devices fail to deal effectively with solid waste.